Has anyone gotten headaches from methotrexate?

Hi, I started taking just 5 mg. of methotrexate each week for my Seronegative RA. I only did 2 weeks worth and the doctor asked me to hold off until I get the headaches checked out. I do not have a headache hx. and they started almost immediately after starting. I still have these headaches almost 2 weeks after my last dose. They move from the back of my skull to the forehead area. I have not been getting regular sleep since being on Prednisone (10 mg/day) plus it is the change of season (upstate NY). Seeing my primary tomorrow. Any help would be appreciated.

Responses (7)

Hello Retiredelfin and welcome to DC. I hope you enjoy your experience here. I have taken methotrexate and remacade infusions without issue and totally uneventful. With the changing seasons it is possible that you are having severe allergic reactions. What are you taking Prednisone for??? That shouldn't cause headaches either but sometimes it takes a while for the body to get used to new drugs. Headaches can be a sign of many things. Over stimulation can cause headaches because it involves the nerves.

You didn't mention if you have "neck" or cervical issues. I do get "head pain" that goes up the back of my head to both sides of my temples. I have also had cervical spine surgery so that is a given for me.

Hi Mary, Thanks for your answer. Funny thing is you hit the "nail on the head" so to speak. I do have cervical issues. I have severe arthritis at C-4 after C-7 thru C-5 were fused together in 2006. At the same time I started taking the Methotrexate I also popped back into the gym for the first time in months and did a lot of upper body stuff... the doc and I both believe I am having muscle spasms which are causing the headaches. This is all induced from the fact that so many of the smaller upper muscles are so weak that it ends up straining the neck and upper shoulder. I am just waiting for a call from my Rhem Doc to see what she wants to do...

Headache is a side effect of both drugs, methotrexate and prednisone, but I would be much more apt to suspect the prednisone as a cause of headache. Headache is a very common side effect of that drug (prednisone). Prednisone can increase intercranial pressure and some people are very sensitive to this change and it results in headache, plus the pain you describe sounds very much like this (increased intercranial pressure) may be a contributing cause. Perhaps the combination of both drugs together has increased the likelihood of this side effect in you, but if you have stopped the methotrexate 2 weeks ago and you are still on prednisone, and are still getting headaches, that pretty much strengthens my argument that it is likely to be the prednisone rather than the methotrexate. Talk to your Dr and ask him if he thinks perhaps it could be the prednisone.

Also, be sure that you are monitoring your blood pressure. These drugs can sometimes cause an increase of hypertension (high blood pressure-especially the prednisone) and hypertension can cause a nasty headache in some people and this headache wont respond to analgesics either, at least not until the blood pressure is returned to a normal reading. When you feel these headaches, you should get your blood pressure taken. The easiest way is to buy your own home blood pressure monitor. Use the kind with a cuff, not the wrist or finger types because they are not accurate. The cuff kind is most accurate but be sure you have a good cuff fit, not too small or too large as this can give false readings. A pharmacist should be able to help you with this if you need help finding one that fits. You can also take advantage of those monitoring stations at the store or pharmacy.

Take your pressure several times a week at different times of the day and especially when you have headache pain, but not just when you have a headache, you need a baseline too. Be sure to write down your readings and your headache pain level and quality at the time of the reading.

Hi DzooBaby,Wow, I love this website. You guys are great. I have been telling my doctors about it and telling them to share it with their other patients.

The Prednisone does not seem to be negatively effecting me and I started taking that about 6 weeks before the Methotrexate. I do suffer from depression (Viibryd) and I think that once my system got used to it I sort of settled out again. I will tell you that sometimes I cannot really tell how a drug is effecting me until I am off it for a while, as odd as that sounds. I do not know if I know what "normal" feeling is. I just know I seem okay.

Oddly enough, the older I get (50) the lower my blood pressure goes. Yesterday it was 96 over 58. I do see a cardiologist yearly as I have vascular calcification and high cholesterol. She does not want me on meds yet. She says I am too young, God bless her! (heehee).

As I said in the other response, I think it is from muscle sprain/spasm.

I just need to say that I feel so fortunate to be attached to this support group, to know I am not alone. I remember when the doctors used to tell me my pain was in my head I would feel so devastated and scared. Thank you all for being here.

Retiredelfin, I was originally taking 25mg of methotrexate each week, as well as prednisone, for psoriasis. I suffered from AWFUL headaches!! I had sound and light sensitivity and could barely get through the first few days of the week (I took my methotrexate on Sunday nights). The headaches continued for the majority of my duration on methotrexate, but eventually were contained to the first day or two after taking it. I found that getting lots of sleep was one of my only remedies at first. Eventually taking tylenol helped too. I hope this helps, and I wish you the best of luck! Meghan

I agree the Prednisone is most like the precipitating factor in your headaches.Also, if you have a predisposition to any form of depression, prednisone can worsen or cause depression.Prednisone can cause insomnia and mood swings.Methotrexate tablets cause GI problem and can leave you feeling "flu like" up to 48 hrs after taking them.I took 30mgs of methotrexate (weekly) and 20 mgs of prednisone daily. I ended up with ulcers that would not heal (6 yrs of this pain) until I was able to get my methotrexate in a weekly injection.Now, I only have problems with methotrexate when I have to skip my shot for a couple of.weeks due to illness or vacination.

That's a reminder... Get Your Flu Shot!!People with autoimmune illnesses are more likely to catch infectious illnesses. Plus the immune suppresants we take make any infection no small problem!

For your headaches, learned on Dr Oz if you eat 30 to 40 fresh or dried cherries will take your headaches away. I get them and migraines and that has really helped! If you buy cherry juice or cherry pills do the added homework on ensuring they have at least 30 to 49 anthocyanins in it. Way too many companies rip you off with only a decimal amount in it. You must have the amounts I mentioned. Life Extension is the only place I found that has those amounts in their product. I went online and ordered dried cherries and they work every time... I get headaches almost every day. There are other red or dark fruit that will work like blueberries, blackberries, etc. Good luck!

I've been on MTX for over three years now, both oral and injectable form. I was lucky to have never dealt with the stomach/GI issues while on the pills. I was switched to the injections as my Rheumy felt I would benefit from the medication if more if it was absorbed which it does with injections.

I've never taken prednisone for my RA, but I find the MTX dries me out and it give me a headache that is somewhat similar to having had too much to drink! If I drink enough water and avoid caffeine (I have problems with methotrexate "fog" but I know that too much caffeine should be avoided with this drug) then I'm usually okay. If I forget to have more water than I usually have, then I can have a really nasty headache that can last for about a day.

I hope you and your doctor are able to figure out the cause of your headaches and that you find a simple way of resolving them quickly!

Methotrexate causes the buildup of adenosine. This may make a person sleepy and head-achy. Caffeine actually competes for adenosine's receptor, blocking its effects. It seems reasonable that caffeine would actually *help* the headaches caused by MTX, but, of course, you should ask your Dr. first!